The herein disclosed invention finds applicability in the field of cell culture, as well as in the field of tissue substitutes for tissue replacement and for prosthesis.
Attempts at replacing or rebuilding diseased or damaged structures in the human body go back to 3000 B.C. It was not until the middle of the 1900""s, however, that the use of synthetic materials for rebuilding body structures met with widespread and reproducible success. Advances in material science and biomaterials and science have afforded much of the success. The need for new and better implants exists in every field of medicine in which disease or trauma can be treated surgically.
As technology advances continue to improve the state of the art, the standards for successful implants continue to improve including strength, biocompatibility and elasticity. The new research being conducted today on growth factors and controlled drug release tell of the day when implant material will be expected to promote healing, dissipate disease and stimulate tissue regeneration.
The inventors have continued to make improvements to more efficiently produce good quality cells and of sufficient quantity which are able to be transplanted effectively.
Introduction: Interactions between the extracellular and the intracellular environment are known to be mediated by transmembrane glycoprotein receptors called integrins. Consisting of alpha and beta chains, integrins are non-covalently bonded protein complexes. These proteins are present in a whole array of cells, including human chondrocytes. Integrins are known to mediate cell attachment and are also involved in cell signaling pathways (Boudreau1). It has been documented that cartilage homeostasis and metabolism is highly influenced by the interaction between the chondrocytes and the extracellular matrix. The role of integrins as mediators of this interaction on chondrocytes has recently been reported (Lapadula2). It has also been documented that the expression of integrin chains may be inversely correlated to the degree of damage in pathological conditions such as osteoarthritis (Lapadula2).
It has been previously reported that human articular chondrocytes propagated in microcarrier spinner culture produce the extracellular matrix components collagen type II and proteoglycans more actively than cells in monolayer culture (Frondoza3). The mechanism by which the microcarrier spinner culture promotes the chondrocytic phenotype is not clear. The present study tests the hypothesis that maintenance of chondrocytic phenotype in microcarrier spinner culture may involve integrin xcex21. The inventors have immunolocalized integrin xcex2-1 while the cells are still attached to the collagen beads. The main goal was to visualize the expression of integrin xcex2-1 on chondrocytes without disrupting the cell-material interaction.
Methods: Cartilage was obtained from two different tissue sites: (a) knee cartilage from osteoarthritic patients at the time of total knee replacement, (b) nasal cartilage from patients during nasal septum reconstruction. Chondrocytes isolated by collagenase digestion were directly seeded at 4xc3x97103 cells/cm2 onto collagen microcarriers (Cellagen(trademark) 100-400 xcexcm derived from bovine corium, ICN, Cleveland, Ohio) previously described (Frondoza3). Microcarrier spinner cultures were incubated at 37xc2x0 C., 5% CO2 for fourteen days. Chondrocytes were sedimented in conical tubes and then aliquoted onto microscope slides. Viability of chondrocytes was determined using trypan blue vital dye. Chondrocytes were transferred to microscope slides, fixed with 2% paraformaldehyde, and air-dried. Chondrocytes on microcarriers were then immunostained using immunoperoxidase with monospecific antibodies for xcex21 (Chemicon International, Inc.), collagen types I and II (Fisher Scientific, Pittsburgh, Pa.); and keratan sulfate (ICN Biomedicals, Inc., Aurora, Ohio).
Total RNA was isolated by the TRIzol Reagent method (Life Technologies, Rockville, Md.). A total cDNA library was synthesized using the Advantage RT-PCR Kit (Clontech Laboratories, Palo Alto, Calif.) with the Oligo (dT18) primer. The resulting reverse transcriptase product was expanded using the SuperTaq Plus (Ambion, Austin, Tex.) PCR Kit and specific primers for collagen type II, type I, aggrecan and the housekeeping genes GADPH and ribosomal RNA S14 subunit. The PCR products were analyzed by agarose gel electrophoresis.
Results: Cells attached to the surface of microcarriers remained viable after two weeks in culture. Chondrocytes isolated from knee or nasal cartilage displayed similar growth patterns and immunostaining characteristics. Microcarriers are seen covered by cells with their surrounding dense extracellular matrix. Many microcarriers exhibited halo-like outgrowths of cells with their matrix-like material. Cells on microcarriers stained more intensely for integrin xcex2, collagen type II, and keratan sulfate. Microcarriers were seen forming clusters of up to 8 beads. There was insignificant staining for collagen type I, and also when the primary antibodies were omitted. Expression of xcex21 integrin, collagens type I and II and proteoglycans was verified with the RT-PCR semi-quantitative analysis.
The inventors have found that xcex21 integrin is strongly co-expressed with collagen type II and proteoglycans by chondrocytes on microcarrier spinner culture. Cell inside-out and outside in signaling, as well as regulation of extracellular matrix metabolism, have been documented to be integrin-mediated (Lapadula2). Microcarrier spinner culture, a biomechanically active environment, may promote and enhance integrin xcex21 expression on chondrocytes, as well as their participation in the maintenance of the original chondrocyte phenotype. The inventors intend to employ integrin expression as a measure of viability of chondroctyes.
Introduction: A novel approach to repair articular cartilage currently being investigated, is cell therapy. Cells are transplanted by themselves or transplanted in a delivery vehicle such as resorbable polymers. As an avascular and alymphatic tissue, articular cartilage does not adequately heal and the repair tissue is frequently fibrocartilage. The repair consists primarily of collagen type I, rather than collagen type II which is characteristic of hyaline articular cartilage. The proteoglycan content is altered from high (aggrecan) to low molecular weight. The inability of cartilage to heal is also attributed to the limited capacity of chondrocytes, the only cellular constituent of cartilage to proliferate and produce components of the surrounding extracellular matrix (Buckwater4). Alteration in the chemical composition of articular cartilage leads to physical changes that compromise the biomechanical function of the joint.
A major problem in the use of cell-based therapy is the limited number of cells capable of producing the appropriate extracellular matrix that constitute hyaline cartilage. The inventors have propagated chondrocytes from three distinct cartilaginous tissues: the knee, nose, and ankle. Propagation has taken place on collagen microcarriers using the suspension spinner culture technique. Collagen microcarrier spinner culture promotes the chondrocytic phenotype of cells retrieved from different cartilage sites. It is obvious that additional tissue sources of chondrocytic cells are desirable and provide additional donor pool of cells for articular cartilage repair. This is a major object of this invention.
Cartilage was obtained from three different tissue sites: (a) knee cartilage from 5 osteoarthritic patients at the time of total knee replacement, (b) ankle cartilage from 5 patients with vascular disease undergoing below the knee amputation, and (c) nasal cartilage from 5 patients during nasal septum reconstruction. Chondrocytes isolated by collagenase digestion were directly seeded at 4xc3x97103 cells/cm2 onto Cellagen microcarriers (100-400 xcexcm derived from bovine corium, ICN, Cleveland Ohio) or as monolayer culture as previously described. Monoalyer and microcarrier spinner cultures were incubated at 37xc2x0 C., 5% CO2 for fourteen days. Chondrocytes were harvested and cell samples enumerated in trypan blue vital dye or were cytocentrifuged onto microscope slides using Cytospin II (Shandon Lipsha). The cytospun cells were immunostained using monospecific affinity purified antibodies to collagen types I and II (Fisher Scientific, Pittsburgh, Pa.); and for proteoglycans using monospecific antibodies to: keratan (ICN Biomedicals, Inc., Aurora, Ohio), chondroitin-4, chrondotin-6 sulphate and unsulphated chondroitin. The rest of the cells were frozen for subsequent RNA isolation.
Total RNA was isolated by the TRIzol Reagent method (Life Technologies, Rockville, Md.). A total cDNA library was synthesized using the Advantage RT-PCR Kit (Clontech Laboratories, Palo Alto, Calif.) with the Olgio (dT18) primer. The resulting reverse transcriptase product was expanded using the SuperTaq Plus (Ambion, Austin, Tex.) PCR Kit and specific primers for collagen type II, type I, aggrecan and the housekeeping genes GAPDH and ribosomal RNA S14 subunit. The PCR products were analyzed by agarose gel electrophoresis.
Chondrocytes isolated from knee, nasal and ankle cartilage proliferated in matching monolayer and microcarrier spinner culture. Within two weeks, cell numbers increased up to 12 fold in monolayer culture while cells multiplied up to 17 fold in microcarrier spinner culture.
The inventors found that chondrocytes taken directly from knee, nasal or ankle cartilage expressed collagen type II and aggrecan but not collagen type I. Tests show representative RT-PCR profiles of mRNA expression, of matched monolayer and spinner cultures. Propagation of chondrocytes from three cartilage sites in suspension or spinner culture maintained the expression of collagen type II while decreasing the expression of collagen type I. In contrast, propagation of matching chondrocytes in monolayer culture increased the expression of collagen type I. There was no detectable change in aggrecan expression when chondrocytes were propagated either as monolayer or spinner culture. The intensity of immunostaining for collagen type I also increased in chondrocytes from all three cartilage sites propagated as monolayer cultures. The immunostaining pattern of collagen type II, and proteoglycans appeared the same under both culture conditions.
The present study confirms the advantage of propagating chondrocytes in collagen microcarrier spinner culture and that chondrocytes retrieved from cartilaginous sites of the nose, knee and ankle are able to multiply and maintain features of their original phenotype. This observation suggests the possibility that other cartilaginous tissue donor sites may provide functional chondrocytes. Availability of chondrocytes capable of producing extracellular matrix that resembles articular cartilage offers an alternative approach for cell-based repair of cartilage defects. Knee, nose and ankles are attractive sources of chondrocytes and will facilitate greatly in accomplishing the objectives of this invention.
Articular chondrocytes possess the ability to sense and respond to changes in their mechanical environment, although the cellular mechanisms by which this phenomenon occurs are not fully understood. One possible pathway involves the xcex21 integrins, which have been shown to mediate binding of chondrocytes to a variety of matrix components [Salter5]. Few studies have examined the effect of mechanical stimulation on integrin expression by chondrocytes. Holmvall6 analyzed xcex21 integrin mRNA expression by chondrocytes and found no change or a decrease in response to applied cyclic strain. The purpose of the present study was to determine, using metabolic labeling and immunoprecipitation techniques, whether cyclic mechanical strain applied to human chondrocytes in an in vitro culture system could modulate de novo synthesis of xcex21 integrins.
Methods: Non-fibrillated articular cartilage was obtained from the knees of two patients undergoing total knee arthroplasty. Chondrocytes were isolated by collagenase digestion, seeded onto type I collagen microcarriers in siliconized spinner flasks or into monolayer culture and incubated at 37xc2x0 C., 5% CO2 for 14 days. Previously (Frondoza3) showed that chondrocytes grown in a microcarrier spinner culture system proliferate and retain their chondrocytic phenotype. Chondrocytes were harvested from the microcarriers or monolayer cultures, plated onto type I collagen-coated flexible-bottom wells (Flexcell International), and allowed to adhere for 48 h. For the final 4 h, the cells were incubated in cys-free, met-free medium. 20 xcexcCi/ml of [35S]-labeled cysteine and methionine was then added to each well, and the wells were subjected to cyclic strain at 0.5 Hz, using a computer-controlled strain apparatus with a vacuum pressure of xe2x88x9220 kPa; replicate samples were maintained under static conditions. After mechanical stimulation, the cells were lysed using buffered 1% Triton X-100 and precleared with 15 xcexcl protein G-agarose for 1 h. Following centrifugation, the supernatant from each sample was reacted with murine anti-xcex21 monoclonal antibody and 15 xcexcl protein G-agarose for 2 h. Each sample was then eluted from the agarose beads by boiling, separated by SDS-PAGE, and analyzed by autoradiography.
RNA was isolated from trypsinized cells and used to create a total cDNA library. Aliquots of the reverse transcriptase product were then expanded by PCR, using primers for the integrin sequence as well as the housekeeping gene S14 (to ensure loading of equal volumes). The PCR products were analyzed by agarose gel electrophoresis.
With cells grown in monolayer culture, autoradiography of the immunoprecipitation products revealed dark bands corresponding to xcex21 integrin subunits and fainter bands corresponding to coprecipitated a subunits, as determined by comparison with 14C molecular weight standards. Mechanical stimulation produced no significant change. In contrast, cells from spinner culture maintained under static conditions exhibited a faint xcex21 band while mechanical flexing produced intense xcex21 and xcex1 bands. In controls using goat anti-chicken IgG as an irrelevant antibody, no integrin bands were seen. In both monolayer and spinner culture cells, RT-PCR revealed no change in mRNA expression in response to mechanical strain.
This study demonstrates that de novo synthesis of xcex21 integrins by cultured human chondrocytes can be increased by applied cyclic strain. This effect was more pronounced in cells grown in spinner culture, which under static conditions exhibit lower levels of xcex21 integrin expression than cells from monolayer. No change in mRNA expression was seen, suggesting that this response is a post-translational event, consistent with previous findings [Holmvall6]. These observations suggest that xcex21 integrins are involved in mediating the response of chondrocytes to changes in their mechanical environment. Cyclic strain during culture of chondroctyes will produce chondrocytes which are more effective for transplantation.
Introduction: The ability of chondrocytes to sense and respond to changes in their mechanical environment depends on interactions between the cells and the cartilage extracellular matrix. These interactions are mediated by the integrin family of cell surface proteins [Salter5, Lapadula2]. The inventors we have shown that chondrocytes propagated on type I collagen microcarriers in a spinner suspension system proliferate and maintain their chondrocytic phenotype [Frondoza3]. The purpose of the present study was to characterize, using immunofluorescence techniques, integrin expression by chondrocytes grown in a spinner culture system or in monolayer culture and then propagated on flexible silicone membranes, both in the presence and absence of applied cyclic mechanical strain.
Methods: Non-fibrillated articular cartilage was obtained from the knees of patients undergoing total knee arthroplasty. Chondrocytes were isolated by collagenase digestion, seeded onto type I collagen microcarriers in siliconized spinner flasks or-into monolayer culture and incubated at 37xc2x0 C., 5% CO2 for 14 days. Cells were then harvested from the microcarriers or monolayer cultures and plated onto type I collagen-coated flexible-bottom wells (Flexcell International). After allowing the cells to adhere for 48 h, the wells were subjected to cyclic strain at 0.5 Hz, using a computer-controlled strain apparatus with a vacuum pressure of xe2x88x9220 kPa; replicate samples were maintained under static conditions. Cells were recovered from the wells by digestion with 0.25% trypsin and reacted with murine monoclonal antibody specific for human xcex21, xcex15, or xcex1v integrin subunit followed by FITC-conjugated goat anti-mouse F(abxe2x80x2)2 fragment. After fixation with 2% paraformaldehyde, 104 consecutive cells from each sample were analyzed by flow cytometry, with the results expressed as a histogram with respect to fluorescence intensity. Mean fluorescence of each sample was estimated by the position (channel number) of the peak of the unimodal histogram. In addition, cells stained for xcex21 were analyzed by laser-scanning confocal microscopy.
Results as shown in FIG. 1: For two cases with matched monolayer and spinner cultures, xcex21 integrin expression by chondrocytes propagated in monolayer was 1.8-5.5 times higher than that of cells from spinner culture, as determined by comparison of the flow cytometry histograms. In one case, sufficient cells were available for analysis of xcex15 and xcex1v expression, which were 10% and 37% higher, respectively, in cells from monolayer as compared to spinner culture. Mechanical flexing had a variable effect on xcex21 integrin expression by chondrocytes in monolayer, with a 17% decrease in fluorescence in one case and a 15% increase in the other case (FIG. 1), as compared with static controls. In contrast, mechanical flexing of chondrocytes from spinner culture resulted in a consistent 21-50% increase in xcex21 expression (FIG. 1). With the a subunits, mechanical flexing of cells from spinner culture resulted in 5% and 36% increases, respectively, in xcex15 and xcex1v expression, while monolayer cells underwent decreases of 13% and 5%. Confocal microscopy revealed diffuse membrane staining for xcex21 subunit, with more intense staining seen in cells from monolayer culture. Mechanical stimulation resulted in a greater increase in staining, however, in cells from spinner culture.
This study demonstrates that xcex11, xcex15, and xcex1v integrin expression by human chondrocytes in vitro can be modulated by culture conditions. Specifically, chondrocytes grown in monolayer, which gradually assume a more fibroblastic phenotype, express higher levels of integrins on their surface than chondrocytes propagated in microcarrier spinner culture, with the most pronounced effect seen with the xcex21 subunit. However, cells from spinner culture (which maintain a chondrocytic phenotype) exhibit a relatively greater increase in integrin expression in response to applied cyclic strain, while cells grown in monolayer had a variable response. These results suggest that integrins are involved in mediating the response of chondrocytes to changes in their mechanical environment. Spinner culture along with cyclic strain are visualized as being able to produce better quality chondrocytes.
Chondrocytes, the cellular constituent of cartilage, have a limited capacity to proliferate but are metabolically active. Following trauma or disease, damaged cartilage oftentimes does not heal. An approach for solving this problem is to repair cartilage defects by transplantation of tissue-engineered biomaterials that can substitute for damaged cartilage. This material can be seeded with chondrocytic cells capable of producing cartilaginous tissue. The tissue engineered product thus consists of cells delivered in a scaffold. Several types of scaffolds are being investigated for cell seeding including collagenous materials and resorbable polymers. However, each of these has limitations, thus there is still the need to identify an appropriate material.
The natural polymer chitosan is a potential candidate as a biocompatible chondrocyte scaffold. Chitosan is the product of the partial deacetylation of the natural polysaccharide chitin, which is found in the exoskeletons of insects and marine invertebrates. Chitosan has been suggested to possess biological and material properties suitable for clinical applications. It is reported to be non-toxic and bioresorbable when used in human and animal models. Previous work in this laboratory has demonstrated that cells cultured on chitosan-coated surfaces remain viable and maintain a morphology similar to that displayed by osteoblasts and chondrocytes in vivo (Lahiji8). Based on these observations, we hypothesize that chitosan can serve as a supporting scaffold for the growth of chondrocytic cells. The purpose of this study was to identify a chitosan formulation that promotes the growth and extracellular matrix production of chondrocytes.
Materials and Methods: Seven different formulations of chitosan were evaluated. Preparation xe2x80x9cAxe2x80x9d consisted of 3% (w/v) chitosan in 1M HAC neutralized with sodium bicarbonate and then immersed in a methanol solution. Preparation xe2x80x9cBxe2x80x9d was produced by sandwiching a chitosan solution [2% (w/v) in 49% (v/v) water and methanol solution] between two layers of solid sodium bicarbonate. Preparation xe2x80x9cCxe2x80x9d was prepared by the phase inversion method in which 3% chitosan in 1M HAC was immersed in an excess of methanol for 5 days. Preparation xe2x80x9cDxe2x80x9d was prepared by mixing a 3% chitosan solution with an excess of sodium bicarbonate to form a paste. The bicarbonate was removed and the material was placed into a 1M NaOH solution, then washed in deionized water. Preparations xe2x80x9cExe2x80x9d-xe2x80x9cGxe2x80x9d were frozen as 1.00% (xe2x80x9cExe2x80x9d), 1.25% (xe2x80x9cFxe2x80x9d), and 1.5% (xe2x80x9cGxe2x80x9d) chitosan solutions. The solutions were subsequently placed in 1M NaOH, and then washed in phosphate buffer to obtain a physiological pH. The gels were refrozen for lyophilization. In all cases except for preparation xe2x80x9cBxe2x80x9d, chitosan was dissolved in 1M acetic acid.
Chondrocytes were isolated from: (a) articular cartilage retrieved from osteoarthritic patients undergoing total knee replacement; and (b) nasal cartilage from patients undergoing nasal septum reconstruction. Chondrocytes isolated by collagenase digestion were propagated by seeding 4xc3x97103 cells/cm2 onto Cellagen microcarrier (100-400m derived from bovine corium, ICM, Cleveland Ohio). Spinner cultures were incubated at 37xc2x0 C., 5% CO2 until ready for use. Chitosan sponges were cut into 0.5 cm3 cubes and then seeded with 1xc3x97106 cells in 40 xcexcl of media. They were analyzed at various time points after seeding. Replicate sponges were paraffin embedded for H-E and toluidine blue staining. Another set of sponges was OCT embedded for frozen sections. Collagen and proteoglycans were visualized by using monospecific antibodies against collagen types I, II and keratan sulfate. To analyze proteoglycans, the seeded sponges were pulsed for 60 hours with 50 xcexcCi/mL 35S04. The proteoglycans were extracted from both the spent media and the sponges using 4M guanidinium HCl for 24 hours at 4xc2x0 C. The extracts were dialysed against ddH2O to remove unincorporated label. The Dc protein assay from BioRad was used to assess protein concentration in the cell associated fractions (CAF). The protein concentration in CAF was used to normalize the total CPM in each fraction.
Results: Of the seven chitosan formulation tested, preparations xe2x80x9cExe2x80x9d (1%) and xe2x80x9cFxe2x80x9d (1.25%) best facilitated cellular permeation and attachment. However, xe2x80x9cExe2x80x9d was friable and fell apart with handling. Preparations xe2x80x9cFxe2x80x9d was firmer and could be manipulated with ease. Chondrocytes from knee or nasal cartilage infiltrated the xe2x80x9cFxe2x80x9d sponge readily. The seeded chondrocytes proliferated in the chitosan sponges. Chondrocytes exhibited spherical morphology surrounded by an amorphous extracellular matrix-like material. They displayed intense immunostaining for collagen type II and keratan sulfate. Immunostaining for collagen type I was insignificant. The specificity of the staining was verified by omitting the primary antibodies or by substituting irrelevant anti-human Ig antibody.
Analysis of 35SO4 incorporation showed that chondrocytes-seeded in replicate chitosan xe2x80x9cFxe2x80x9d scaffolds (Sc1 and Sc2) synthesized proteoglycans more actively than matching chondrocytes propagated in monolayer (M1, M2) culture (FIG. 2). Newly synthesized proteoglycans were detectable in the cell associated fractions and were also exported to the medium.
Human chondrocytes propagated in microcarrier spinner culture and then seeded into chitosan scaffolds multiplied and continued synthesis of collagen II and proteoglycans. That chondrocytes continue to produce the extracellular matrix-like material similar to hyaline cartilage indicates that the chitosan xe2x80x9cFxe2x80x9d sponge formulation is an attractive candidate for preparation of cell-material construct. Availability of a biocompatible tissue engineered construct would be useful for repairing cartilage defects.
Recent development in tissue engineering has focused on the potential use of cell-seeded scaffolds for the repair of articular cartilage. Articular cartilage is unique in that it has limited capacity to heal and attempts to repair results in formation of fibrocartilage. The repair tissue has altered biochemical and physical properties, which compromises the mechanical function of the joint. An approach for solving this problem is to repair cartilage defects by transplantation of tissue-engineered biomaterials that can substitute for damaged cartilage.
Arabinogalactan-chitosan polymers and particularly dialdehyde arabinogalactan (DAAG) are an attractive candidate to serve as biocompatible chondrocyte scaffolds. Dialdehyde arabinogalactans (DAAG) are highly branched natural polysaccharide whereas chitosan is the product of the partial deacetylation of chitin, which is found in the exoskeletons of insects and marine invertebrates. Both dialdehyde arabinogalactans (DAAG) and chitosan have been suggested to possess biological and material properties suitable for clinical applications (Falk7, Lahiji8). They are non-toxic and bioresorbable when used in human and animal models. Previous work in this laboratory has demonstrated that cells cultured on chitosan-coated surfaces remain viable and maintain morphology similar to that displayed by osteoblasts and chondrocytes in vivo (Frondoza3). Based on these observations, the inventors hypothesize that DAAG-chitosan polymeric construct could serve as supporting scaffold for the growth of chondrocytic cells. The purpose of this study was to determine whether DAAG-chitosan polymers constructs could support the growth and extracellular matrix production of human articular chondrocytes.
Materials and Methods:
Dialdehyde arabinogalactans (DAAG) were mixed with 2% v/v chitosan in acetic acid at 5%, 10%, 20% or 40%. The mixtures were stirred at 37xc2x0 C. for 3 to 5 days and the physiological pH was adjusted with NaOH. Another set of the same preparations was reduced using sodium borohydride. The final mixtures were then washed and lyophilized.